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26 Cards in this Set

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Ptosis without Miosis

Ptosis = Drooped eyelid


Miosis = Dilated pupil


If no miosis then sympathetic supply still intact


Causes: Bells palsy, injury, brain carcinoma, cerebral aneurysm

Trunk Ataxia

A loss of coordinated muscle movements for maintaining normal posture


Causes: Tumour or foreign body

Stridor

Rasping on inspiration, worse with coughing


Causes: foreign body or tumour

Third heart sound

Rare extra heart sound shortly after S1 and S2, due to reduced atrial complence causing filling sound


Causes: congestive heart failure

Hoover Sign

Inward movement of lower ribcage during inspiration.


Due to hyperinflation - causes diaphragm to flatten and then periodically contract inwards on inspiration

5 NB signs of hyperinflation

Hoover sign


Decreased cardiac dullness


Displaced liver border


Tracheal tug


Bronchial breathing

Prolonged expiration

Response to airway obstruction - exert effort to breathe out


Causes: acute, asthma, COPD, emphysema, bronchial carcinoma, bronchitis

Heaving apex beat

A sustained and forceful heave caused by an obstruction, increased contact time of the apex with the chest wall

Causes: aortic stenosis, hypertension

Tapping apex beat

Palpable S1


Causes: mitral or (rarely) tricuspid valve stenosis

Ankle clonus

Abnormal ankle reflexes, elicited by dorsiflexion

Projectile vomiting

Causes: raised ICP, gastric outlet obstruction (GOO)

Fourth heart sound

"atrial kick", late diastolic sound, disapears when listening with bell


Causes: systemic hypertension, hypertrophic obstructive cardiomyopathy (HOCM)

Babinski sign

Indicative of upper motor neuron lesion


To elicit: stroke sole of foot from heel upwards in "J", if positive big toe extends and other toes fan out

Dysdiadochokinesis

Inability to preform rapidly alternating pronation and supination of the hand


Causes: cerebellar dysfunction

Brudzinski sign

Positive in meningitis


To elicit: Flex head, then hips and knees flex to compensate for stiffness

Synovial thickening

Inflammation of synovium causes it to thicken - leads to accumulation of fluid leading to pain and swelling


Causes: rheumatoid arthritis

Dupuytren contracture

Visible and palpable thickening and contraction of the palmar fascia causing permanent flexion, most often of the ring finger. Often bilateral and occasionally affects the feet.


Pathogenisis - palmar fascia contains abnormally high levels of xanthin


Causes: alcoholism (not liver disease), some manual workers, often familial

Coin sign

Diagnostic test for punctured lung


To elicit: coin held over suspected are of puncture site, then hit with another coin. If you listen at the back and hear a tinkling sound, test is positive

Caput Medusa

Varicose veins radiating from the umbilicus (appearance of engorged and distended para-umbilical veins)


Causes: portal hypertension (decompressed by portal system shunting)

Chvostec sign

Positive in tetany - neurological syndrome characterised by muscle twitches, cramps and carpopedal spasm


To elicit: Slight tap just anterior to external auditory meatus excites facial nerve, causing a unilateral spasm of the orbicularis oris or orbis muscles


Tetany causes: central and peripheral nervous system irritability causes by low serum levels of ionized calcium, hyperventilation, hypoparathyroidism, rickets and uremia

Hairy tongue

Unusually dark and/or hairy appearance of the tongue. Harmless condition caused by fungus growing on surface of tongue.


Associated with: old age, smoking, antibiotics, poor oral hygiene and tooth loss

Koplik spots

Pathognomic for measles


Occurs before the skin eruptions on the buccal mucosa. Appear as small red dots with a central bluish white speck.

Casal's necklace

Dermatitis completely or partially surrounding the lower neck.


Found in Pallagra (Vit B3 niacin deficiency)

Central cyanosis

Evident when deoxygenated hemoglobin in the blood reaches 5g/dl - seen at lips and tongue.


Always indicative of underlying disease, cardiac or pumonary.

Asbestos exposure

Leads to lung fibrosis.


Usually seen in ship yard or cnstruction workers, plumbers and boiler makers

Russet (rusty) sputum

reddish brown, blood stained expectoration characteristic of lobar pneumococcal pneumonia